Individual
MS. MICHELLE JANE BOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 389-0269
Mailing address
1910 CHARLES ST, DUPONT, WA 98327-7740
(253) 389-0269
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 60090664
WA
367500000X
Certified Registered Nurse Anesthetist
690107
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60086711
WA
Other
Enumeration date
12/16/2005
Last updated
02/25/2019
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